Vol 16, No 5 (2010)

Articles
Kolonka redaktora
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Medical Journal of the Russian Federation. 2010;16(5):3-3
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Mediko-organizatsionnye aspekty reabilitatsii bol'nykh s vospalitel'nymi zabolevaniyami i povrezhdeniyami chelyustno-litsevoy oblasti v ambulatornykh usloviyakh
Polunina N.V., Kopetskiy I.S., Goncharova A.V., Kostin A.P.
Abstract
Medical rehabilitation is an active therapeutic process the goal of which is to achieve complete recovery of disease- or injury-induced dysfunctions. Medical rehabilitation allows the working ability of patients to be regained, but also favors their rapid social adaptation to altered living conditions. Rehabilitative measures contribute to the changed pattern of medical behavior, normalized psychoemotional status, and molded healthy lifestyle elements.
Medical Journal of the Russian Federation. 2010;16(5):4-7
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Issledovanie urovnya mozgovogo natriyureticheskogo peptida na vysote fizicheskoy nagruzki u bol'nykh s khronicheskoy serdechnoy nedostatochnost'yu i sokhrannoy sistolicheskoy funktsiey levogo zheludochka
Gendlin G.E., Borisov S.N., Storozhakov G.I., Melekhov A.V.
Abstract
The measurement of the concentration of brain natriuretic peptide (BNP) and its N-terminal fragment (NT-proBNP) has currently enjoyed wide application in the diagnosis of chronic heart failure (CHF); however, the use of these markers for the diagnosis of CHF with preserved left ventricular (LV) systolic function has been inadequately studied. The purpose of the investigation was to study the level of NT-proBNP at peak exercise in patients with CHF and preserved LV systolic function as compared with changes in NT-proBNP concentrations during exercise in healthy individuals. The serum concentration of NT-proBNP was determined in 22 patients with CHF and preserved LV systolic function and in 15 subjects without CHF at rest and peak treadmill exercise testing by the standard Bruce protocol. In the CHF group, the increment in NT-proBNP at peak exercise (d NT-proBNP) was 3.2 times greater than that in the control group (p = 0.02) and the percentage increase in NT-proBNP (d NT-proBNP/NT-proBNP at rest 100%) was 3.4 times higher than that in the controls (p = 0.02). In the patients with CHF, the ratio of d NT-proBNP to exercise duration was 5.4 times greater than that in the subjects without CHF (p = 0.003) and that of percentage increase in NT-proBNP to exercise duration was 7 times higher than that in the controls (p = 0.004). The absolute and percentage increments in NT = proBNP correlated with exercise duration (p = 0.009 and p = 0.035, respectively); the percentage increase in NT-proBNP also correlated with ejection fraction (p = 0.016).
Medical Journal of the Russian Federation. 2010;16(5):8-11
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Izuchenie assotsiatsii polimorfizma genov b-adrenoretseptorov s urovnem arterial'nogo davleniya i razvitiem gipertrofii miokarda u bol'nykh gipertonicheskoy bolezn'yu
Minushkina L.O., Nikitin A.G., Brazhnik V.A., Nosikov V.V., Zateyshchikov D.A.
Abstract
The investigation was undertaken to study an association of the polymorphic markers Gly389Arg and Ser49Gly of the ADRB1 gene, Gly16Arg and Glu27Gln of the ADRB2 gene, Trp64Arg of the ADRB3 gene and C825 of the GNB3 gene with the level of blood pressure (BP) and the structural and functional features of the left ventricular (LV) myocardium in patients with hypertensive disease (HD). One hundred and seventy-seven hypertensive patients, including 83 (46.9%) males and 94 (53.1%) females) were examined. Their mean age was 60.6±0.76 years. A study group comprised 19 (10.9%) patients with grade 1 arterial hypertension (AH); 57 (32.8%) with grade II AH, and 101 (56.3%) with grade III Ah. LV structural features were examined by echocardiography. No association was found between the genotypes and BP levels for the polymorphic markers Ser49Gly of the ADRB1 gene, Gly16Arg and Glu27Gln of the ADRB2 gene, Trp64Arg of the ADRB3 gene, and C825 of the GNB3 gene. As for the polymorphic marker Gly389Arg of the ADRB1 gene, genotype Arg/Arg carriers had elevated systolic and diastolic pressures. There were 40 patients without signs of LV hypertrophy (LVH) and 137 patients with increased LV myocardial mass index in the study group. The patients with LVH were older (p = 0.001) and had a longer history of HD (p = 0.018), higher systolic BP (p = 0.008) and a higher body mass index (p = 0.001). Among the patients with LVH, there were more females (57.7 and 37.5%; p = 0.025) and more patients with type 2 diabetes (17.5 and 5.0%; p = 0.040). The frequency of genotype Arg/Arg of the polymorphic marker Gly398Arg of the ADRB1 gene was ascertained to be significantly higher in the patients with LVH [p = 0.008; OR 2.32 (1.34-4.11)]. Multivariate analysis showed that age, systolic BP levels, overweight, and carriage of genotype Arg/Arg of the polymorphic marker Gly389Arg of the ADRB1 gene were independently associated with increased LV myocardial mass.
Medical Journal of the Russian Federation. 2010;16(5):11-16
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Analiz rezul'tatov laparoskopicheskikh appendektomiy
Sazhin A.V., Klimiashvili A.D., Kodzhoglyan A.A., Mosin S.V., Mirzoyan A.T., Laypanov B.K.
Abstract
Mini-invasive technologies improve the results of treatment for acute appendicitis (AA). The General Surgery Clinic, Pediatric Faculty, N. I. Pirogov RMU, treated 1392 patients with different forms of appendicitis in 2005 to 2009. Conventional open appendectomy (AE) was carried out in 366 (26.3%) patients. Endovideo-assisted surgery was performed in 1026 (73.7%) patients with suspected AA; laparoscopy excluded acute surgical pathology in 118 (11.5%); 908 (85.5%) patients were operated on by various procedures after laparoscopic verification of AA. As more experience was accumulated, the share of laparoscopic AEs of all the performed AEs increased from 13.9% in 2005 to 94.1% in 2009. The mesoappendix was treated with various electrosurgical techniques, a stump was formed by ligature; an intracorporeal purse-string suture was used in 4.3% of cases.
Medical Journal of the Russian Federation. 2010;16(5):16-18
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Biomarkery sistemnogo vospaleniya i uroven' mikroelementov Zn++ i Cu++ pri otsenke tyazhesti sostoyaniya khirurgicheskikh bol'nykh s gnoynymi ranami myagkikh tkaney
Sviridov S.V., Fedorov S.V., Alieva T.U., Rozumeyko V.P.
Abstract
The trace elements Zn++ and Cu++ versus C-reactive protein (CRP) and transferrin (TF) were studied in 45 surgical patients (26 males and 19 females) aged 46.6±17.3 years with soft tissue purulent wounds (STPW) in the postoperative period. The baseline CRP levels were found to be 3.8-43 times higher in all the patients. The CRP concentration was greater than 100 mg/l in 75.6% of the patients. There was substantially decreased TF level during the full-scaled picture of STPW, which is indicative of the development of moderate and protein-energy deficiency. Tests for plasma Zn++ revealed that hypozincemia was present in 91.1% of the patients; its values were less than 8.2 μmol/l in 66.6%. A negative correlation was established between CRB levels and Zn++ concentrations (r = -0.4). Cu++ concentrations were less than 11.1 μmol/l in 20% of the patients and greater than 22.0 μmol/l in 17.8%. Of great importance was Cu++/Zn++ ratio (normal values 0.9-1.13). The latter was ascertained to be normal only in 6.7%. There was a direct correlation between the CRP values and the Cu++/Zn++ ratio (r = 0.3) and a negative correlation between the TF levels and Cu++/Zn++ ratio.
Medical Journal of the Russian Federation. 2010;16(5):19-21
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Virusnyy gepatit S. Aktual'nye problemy lecheniya
Zharov S.N., Luchshev V.I., Sanin B.I.
Abstract
The paper shows the leading role of hepatitis C in the structure of infectious morbidity under the present-day conditions. Conventional antiviral therapy was assessed. Possible adverse reactions of this therapy are presented. The results of glycyrrhizic acid therapy are given in patients with hepatitis C. Both viuside and phosphogliv showed noticeable antiviral and hepatoprotective activities. Possibilities of their use in antiviral therapy for hepatitis C were estimated.
Medical Journal of the Russian Federation. 2010;16(5):22-25
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Psikhologicheskiy status u bol'nykh psoriazom
Vasenova V.Y., Karpova A.V., Butov Y.S.
Abstract
The psychogenesis of psoriasis was studied by the Spielberg and Lüscher clinical and psychodiagnostic tests. Cause-and-effect relationships were found in the occurrence and course of psoriasis, which were used to identify 3 clinical types of its development: 1) somatogenic depression-complicated psoriasis; 2) psychogenic depression-associated psoriasis; 3) psoriasis as concomitant pathology of endogenous depression. It has been established that the course of the dermatosis is more frequently complicated by somatogenic depression in female patients and psychogenic psoriasis is commonly a determinant in its development in male patients. The findings formed the basis for correcting affective disorders in patients with psoriasis, which permitted clinical remission to be achieved in a shorter periods of time.
Medical Journal of the Russian Federation. 2010;16(5):25-28
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Sovremennye podkhody k terapii depressiy
Bardenshteyn L.M.
Abstract
The data suggesting that there has been a rise in the number of patients with depressions in the past two decades are analyzed. A tendency towards the chronic course of monopolar depressions and the disabling pattern of these affective disorders are noted. Some pathogenetic mechanisms for development of depressive disorders are considered. Analysis of the results of current clinical psychopharmacological studies has yielded information on the drugs that have high antidepressant activity and cause mild adverse reactions.
Medical Journal of the Russian Federation. 2010;16(5):28-30
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Klassifikatsiya i kharakteristika periodov detskogo vozrasta
Vaganov P.D.
Medical Journal of the Russian Federation. 2010;16(5):30-34
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Kognitivnye narusheniya pri vaskulitakh
Damulin I.V.
Medical Journal of the Russian Federation. 2010;16(5):34-39
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Patogeneticheskaya terapiya bol'nykh tuberkulezom organov dykhaniya
Stakhanov V.A.
Medical Journal of the Russian Federation. 2010;16(5):40-44
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Rol' adenozina i ego retseptorov v patofiziologii zabolevaniy bronkholegochnoy sistemy
Asiyatilova A.M., Ezhova I.S., Aleksandrov O.V.
Medical Journal of the Russian Federation. 2010;16(5):44-46
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Istoriya prepodavaniya farmakologii
Alyautdin R.N., Romanov B.K.
Medical Journal of the Russian Federation. 2010;16(5):46-53
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